Efficacy of interferential current therapy plus exercise compared to sham interferential current plus exercise for pain relief in patients with knee osteoarthritis: A randomised controlled trial.

OBJECTIVE: To compare the efficacy of interferential current (IFC) therapy combined with quadriceps strengthening exercise versus sham IFC plus exercise for pain relief and functional improvement in patients with knee osteoarthritis. STUDY DESIGN: Double-blind randomised controlled trial. SETTING: Outpatient rehabilitation clinic. SUBJECTS: Knee osteoarthritis patients aged 50-85 years with a pain score ≥4/10. METHODS: One hundred forty-four participants were randomly allocated into the study and control groups. The study group received 20 min of IFC therapy (carrier frequency: 4000 Hz, beat frequency: 100 Hz) five times per week for three weeks, while the control group received sham IFC following the same protocol, followed by 10 min of exercise in both groups. Outcome measures included Numeric Rating Scale for Pain, Western Ontario and McMaster Universities Index (WOMAC) score, gait speed, and EuroQol-Five Dimensions-Five Levels questionnaire assessed at baseline, Week 3, and Week 6. Adverse events and patient satisfaction were evaluated at Week 3. RESULTS: At Week 3, the study group demonstrated statistical improvement compared to the control group for Numeric Rating Scale for Pain, WOMAC Total, WOMAC Pain, and WOMAC Stiffness. The mean difference (95% confidence interval) between groups was 0.76 (0.21-1.30), 0.49 (0.03-0.95), 0.63 (0.13-1.13), and 0.62 (0.04-1.20), respectively. However, the mean differences between groups were below the Minimally Clinically Important Difference values for each outcome. Additionally, there were no significant differences between groups at Week 6 for any outcome measure. CONCLUSION: IFC had no effect on pain reduction and functional improvement in patients with mild to moderate knee osteoarthritis.

Does interferential current provide additional benefit to orthopedic rehabilitation for the patients with proximal humeral fractures? A randomized controlled study.

BACKGROUND: Approximately 80% of all proximal humeral fractures (PHFs) are non-displaced or minimally displaced fractures, which can be treated with conservative treatment. This study investigated the effect of interferential current (IFC) added to orthopedic rehabilitation on shoulder function, pain, and disability in patients with PHF. METHODS: This study was a prospective, double-blind, randomized, placebo-controlled conducted in physical medicine and rehabilitation outpatient clinic. Thirty-five patients were randomly separated into the IFC group (n = 18) and the sham group (n = 17). The orthopedic rehabilitation program was applied to all patients by the same physiotherapist three times a week for four weeks. Patients in the IFC group received the intervention for 20 minutes 3 times a week before the exercise. The same pads were performed for the sham group, but no electrical stimulation was applied. Constant-Murley score (CMS) for shoulder function, visual analog scale (VAS) activity pain, disabilities of the arm, shoulder, and hand (DASH) score, and paracetamol intake were recorded post-treatment, at 6 weeks and 18 weeks post-treatment. RESULTS: The demographic and fracture characteristics were not different between the groups. Significant differences were observed in the IFC and sham group in intragroup comparisons of total CMS, VAS activity pain, DASH score, and paracetamol intake over time (p < 0.001). Significant improvement over time was valid for all pairwise comparisons in both groups. However, no significant differences were detected between the IFC and sham group. CONCLUSION: IFC added to orthopedic rehabilitation could not appear to be an electrotherapy modality that could potentially benefit shoulder function and disability in patients with PHF.

Effects of combination therapy and infrared radiation on pain, physical function, and quality of life in subjects with knee osteoarthritis: A randomized controlled study.

BACKGROUND: Knee osteoarthritis (KOA) is a common degenerative articular disease that causes disability and poor quality of life (QoL) of the individuals. Electrotherapeutic agents such as therapeutic ultrasound (US), interferential current (IFC), and infrared radiation are used in the treatment. It is not clear which of these agents is the best in improving these variables. OBJECTIVE: The study aimed to compare the effects of the combined application of US and IFC therapies and infrared radiation on pain, functional activities, and QoL in people with KOA. METHODS: In a randomized controlled study, 60 participants were randomized into two groups, the combination therapy group (CTG) and the infrared radiation group (IRG). Each group received 15-min treatment three times per week for 12 weeks. The visual analog scale (VAS) was used to assess the pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functional activities and the Short Form Health Survey questionnaire for QoL. RESULTS: Participants in the CTG had a significant ( p < 0 . 05 ) reduction in pain and significant ( p < 0 . 05 ) improvement in functional activities and QoL compared to the IRG. CONCLUSION: The results of this study support the use of the combination of IFC and US therapies to reduce pain and improve function and QoL for KOA patients.

Effect of interferential current therapy on forward head posture.

[Purpose] The purpose of this study was to examine the effects of interferential current therapy on the shoulder muscles of subjects with forward head posture. [Subjects and Methods] Thirty volunteers (15 forward head posture, 15 control) participated in this study. Interferential current therapy treatment was conducted for 10 min, three times per week, for 3 weeks on both the upper trapezius and levator scapulae. Subjects were measured anterior both acromion distance and posterior both acromial distance using a ruler, and the forward head posture angle using an electronic application. [Results] Both groups showed significant increases in anterior acromial distance, and decreases in posterior acromial distance and forward head posture angle. [Conclusion] Subjects were concluded that electrical therapy could improve structural alignment; therefore, the implementation of interferential current therapy is expected to be effective for the treatment of forward head posture.

Determination of effective treatment duration of interferential current therapy using electromyography.

[Purpose] This study used electromyography to measure the effective treatment duration of interferential current therapy for muscle fatigue. [Subjects and Methods] Fifteen healthy adult men volunteered to participate in the study (age: 24.2 ± 1.3 years; weight: 67.6 ± 4.92 kg; height: 176.4 ± 4.92 cm). All subjects performed 5 min of isometric back extension exercise to produce muscle fatigue, and were then treated with interferential current therapy for 15 min, with electromyography monitoring (treatment group). After sufficient rest, the exercise was repeated for 5 min and an electromyography signal was acquired for 15 min with no treatment (control group). [Results] In the treatment group, the median frequency shifted to a higher level; the root mean square decreased over time, and then maintained a minimum amplitude. However, there were few changes in the electromyography signal after exercise in the control group. [Conclusion] Electromyography signals can provide information about the effective duration for muscle fatigue treatment as well as the muscle characteristics during treatment. This study should be helpful for clinicians by demonstrating the appropriate duration of therapy for relief of muscle stiffness.

Immediate therapeutic effect of interferential current therapy on spasticity, balance, and gait function in chronic stroke patients: a randomized control trial.

OBJECTIVE: To determine whether a single trial of interferential current therapy (ICT) can immediately alleviate spasticity and improve balance and gait performance in patients with chronic stroke. DESIGN: Randomized, placebo-controlled clinical trial. SETTING: Inpatient rehabilitation in a local center. SUBJECTS: A total of 42 adult patients with chronic stroke with plantar flexor spasticity of the lower limb. INTERVENTION: The ICT group received a single 60-minute ICT stimulation of the gastrocnemius in conjunction with air-pump massage. In the placebo-ICT group, electrodes were placed and air-pump massage performed without electrical stimulation. MAIN MEASURES: After a single ICT application, spasticity was measured immediately using the Modified Ashworth Scale (MAS), and balance and functional gait performance were assessed using the following clinical tools: Functional Reach Test (FRT), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and 10-m Walk Test (10MWT). RESULTS: Gastrocnemius spasticity significantly decreased in the ICT group than in the placebo-ICT group (MAS: ICT vs placebo-ICT: 1.55±0.76 vs 0.40±0.50). The ICT group showed significantly greater improvement in balance and gait abilities than the placebo-ICT group (FRT: 2.62±1.21 vs 0.61±1.34, BBS: 1.75±1.52 vs 0.40±0.88, TUG: 6.07±6.11 vs 1.68±2.39, 10MWT: 7.02±7.02 vs 1.96±3.13). Spasticity correlated significantly with balance and gait abilities (P < 0.05). CONCLUSION: A single trial of ICT is a useful intervention for immediately improving spasticity, balance, and gait abilities in chronic stroke patients, but not for long-term effects. Further study on the effects of repeated ICT is needed.

Detection of Changes on Parameters Related to Heart Rate Variability after Applying Current Interferential Therapy in Subjects with Non-Specific Low Back Pain.

Interferential current therapy (ICT) is an electrotherapeutic intervention that combines the advantages of high permeability from middle frequency currents and efficient tissue stimulation from low frequency currents, delivering the maximum current with high tissue permeability. The aim was to evaluate the effects of ICT on heart rate variability (HRV) and on pain perception in patients with non-specific chronic low back pain (NSCLBP). In the study, 49 patients with NSCLBP were randomly divided into an experimental (EG) and a sham group (SG). All participants received a single intervention, ICT, or simulated intervention. Outcome measures including baseline (sit-down position) and postintervention (prone position) pain, heart rate (HR), time domain parameter (rMSSD), diameters of the Poincaré plot (SD1, SD2), stress score (SS), and sympathetic/parasympathetic (S/PS) ratio were investigated. In both groups, significant statistical differences were found in perceived pain and in all HRV parameters except in HRmax. Between-group comparisons showed statistically significant differences in all variables except for HRmin and HRmean in favor of the experimental group. These changes reported an increase in parasympathetic activity (rMSSD) (p < 0.05) and a decrease in sympathetic activity (increase in SD2 and decrease in SS) (p < 0.001) and perceived pain (p < 0.001), with a greater size effect (η2 = 0.44) in favor of the experimental group. In conclusion, a single session of ICT can shift the autonomic balance towards increase parasympathetic dominance and decrease the sympathetic dominance and intensity of pain perceived by patients with NSCLBP.

Clinical evaluation of the effectiveness of interferential current therapy in the treatment of children with pelvic floor dyssynergia-type constipation: a randomized controlled study.

BACKGROUND: Despite several treatment modalities being described for pelvic floor dyssynergia-type constipation, the clinical evaluation of interferential current therapy (IFC) has not been examined. We aimed to examine the clinical effects of IFC therapy in the treatment of children with pelvic floor dyssynergia-type constipation. METHODS: Between May 2018 and July 2019, this randomized controlled study included sixty-two children (46 boys and 16 girls) with pelvic floor dyssynergia-type constipation; their ages ranged between 7 and 15 years. The children were randomly divided into either the IFC group (n = 31) who received an active IFC therapy to stimulate the pelvic floor and external anal sphincter muscles, three times per week for four successive weeks, or the control group (n = 31) who received sham IFC stimulation. Stool-incontinence frequency per week, stool type, pelvic floor excursion, and myogenic activity of external anal sphincter were evaluated at the baseline, post-treatment, and three months after treatment termination. RESULTS: The baseline evaluation showed non-significant differences between the IFC and control groups (p > 0.05). The post-treatment results showed a statistically significant difference between both groups regarding all variables, favoring the IFC group (p < 0.05). Further, the favorable effect of IFC on all variables continued at the follow-up, three months later. CONCLUSIONS: IFC therapy appears to improve stool-incontinence frequency, stool type, pelvic floor excursion, and myogenic activities of the external anal sphincter in children with pelvic floor dyssynergia-type constipation. These results suggest that adding IFC therapy to the medical treatment could improve the main features of pelvic floor dyssynergia-type constipation.

A novel taping therapy for pain after arthroscopic shoulder surgery: study protocol for a randomised controlled pilot trial.

BACKGROUND: In recent years, the number of arthroscopic shoulder surgeries has increased given that the intervention is minimally invasive. However, postoperative pain is one of the most common symptoms of patients who undergo arthroscopic surgery. Although pharmacological treatments and brachial plexus blocks for reducing pain are currently used, the adherence rate of interventions is low, and adverse effects often occur. Chimsband, made up of silver and optic fibres, is a novel taping therapy that stimulates patients' acupoints and is expected to relieve pain with few adverse effects. The aim of this study is to explore the effectiveness of Chimsband to relieve pain following arthroscopic shoulder surgery. METHODS/DESIGN: This is a randomised, parallel, controlled, exploratory clinical trial. Thirty participants who undergo arthroscopic shoulder surgery will be randomly allocated to an intervention or a control group. Both groups will receive 10 sessions of interferential current therapy within a period of 2 weeks, while the intervention group will additionally receive taping therapy after undergoing physical therapy. Two follow-up visits will be scheduled after the last treatment session. The primary outcome variable will be the difference in the visual analogue scale (VAS) scores between baseline and first follow-up evaluation after the end of 10 treatment sessions. The secondary outcomes will be VAS at the end of the second week, shoulder pain and disability index, range of motion, VAS while sleeping, questionnaire of blood stasis pattern identification at two follow-up visits, and number of bands used per visit. Outcomes will be evaluated at baseline, 2 weeks from visit 1 (+ within 6 days) after commencement, and at 4 weeks from visit 1 (+ within 6 days) follow-up. DISCUSSION: This study will be the first clinical trial to explore the effect and safety of Chimsband on postoperative shoulder pain. It would provide clinical evidence to conduct further taping therapy studies for relieving musculoskeletal pain. TRIAL REGISTRATION: Korean Clinical Trial Registry, KCT0002355 . Registered on 13 June 2017.

The Efficacy and Safety of Transcutaneous Acupoint Interferential Current Stimulation for Cancer Pain Patients With Opioid-Induced Constipation: A Prospective Randomized Controlled Study.

INTRODUCTION: Opioid-induced constipation (OIC) is a principal complication secondary to analgesic therapy for cancer pain patients who suffer moderate to severe pain. In this study, we observe the efficacy and safety of transcutaneous acupoint interferential current (IFC) stimulation in those patients with OIC. METHODS: A total of 198 patients were randomly allocated to the IFC group and control group in a 1:1 ratio. Finally, 98 patients in the IFC group received 14 sessions administered over 2 weeks, whereas 100 patients in the control group took lactulose orally during the same period. Observation items were documented at management stage and at follow-up stage according to Cleveland Constipation Scales (CCS), pain Numeric Rating Scales (NRS) and Patient Assessment of Constipation Quality of Life (PAC-QoL). RESULTS: The total curative effects of the IFC group and the control group were indistinguishable (76.5% vs 70.0%, P = .299). Regarding CCS and PAC-QoL scores, no significant difference was observed between the 2 groups during the management time and at the follow-up stage of week 3 ( P > .05, respectively), but groups were distinguished at the follow-up stage of week 4 ( P < .001 and P = .031, respectively). The pain NRS decreased significantly at management stage week 2 and follow-up stage week 3 and week 4 ( P = .013, P = .041, P = .011, respectively). CONCLUSIONS: Transcutaneous acupoint IFC therapy over acupoints of Tianshu (ST25) and Zhongwan (RN12) may improve constipation and quality of life in cancer patients receiving opiates; further studies are worthwhile.